Healthcare Provider Details

I. General information

NPI: 1023926730
Provider Name (Legal Business Name): MICHELE MARIE FITZGERALD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3830 E VAN BUREN ST
PHOENIX AZ
85008-6920
US

IV. Provider business mailing address

2943 W COUNTRY GABLES DR
PHOENIX AZ
85053-4848
US

V. Phone/Fax

Practice location:
  • Phone: 602-243-7277
  • Fax:
Mailing address:
  • Phone: 505-980-4830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN191839
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: